IL HB 2584: INS-PRIOR AUTH HIV DRUG ACCESS

Illinois HB 2584 amends the Prior Authorization Reform Act and the Illinois Public Aid Code to restrict the use of prior authorization requirements for certain HIV-related prescription drugs. The bill provides that health insurance issuers, the fee-for-service medical assistance program, and Medicaid managed care organizations may not require prior authorization for HIV pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and HIV treatment medications, as well as their therapeutic equivalents approved by the FDA.

The prohibition applies across three distinct coverage contexts: commercial health insurance issuers subject to the Prior Authorization Reform Act, the Illinois fee-for-service Medicaid program, and Medicaid managed care organizations operating under the Illinois Public Aid Code. This dual-statute amendment signals legislative intent to eliminate prior authorization barriers uniformly across both commercial and public coverage arrangements in the state.

The bill's effective date is January 1, 2027. As of the latest recorded action, the bill had a Rule 2-10 Committee/3rd Reading Deadline established as May 31, 2026, indicating the legislation remains in the legislative process and has not yet been enacted into law.